Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Paier-Abuzahra, M; Posch, N; Jeitler, K; Semlitsch, T; Radl-Karimi, C; Spary-Kainz, U; Horvath, K; Siebenhofer, A.
Effects of task-shifting from primary care physicians to nurses: an overview of systematic reviews.
Hum Resour Health. 2024; 22(1): 74
Doi: 10.1186/s12960-024-00956-3
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- Führende Autor*innen der Med Uni Graz
- Paier-Abuzahra Muna
- Posch Nicole
- Co-Autor*innen der Med Uni Graz
- Horvath Karl
- Jeitler Klaus
- Radl-Karimi Christina
- Semlitsch Thomas
- Siebenhofer-Kroitzsch Andrea
- Spary-Kainz Ulrike
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- Abstract:
- BACKGROUND: Task-shifting from primary care physicians (PCPs) to nurses is a means of overcoming PCP shortages and meeting the needs of patients receiving primary care. The aim of this overview of systematic reviews is to assess the effects of delegation or substitution of PCPs' activities by nurses on patient relevant, clinical, professional and health services-related outcomes. METHODS: We conducted a systematic literature search for secondary literature in Medline, Embase, Pubmed, the Cochrane Library, and the Cumulative Index of Nursing and Allied Health Literature (CINAHL). We included systematic reviews and meta-analyses that analysed randomised controlled trials (RCTs) and controlled, prospective trials in English and German. Abstracts and full-text articles were screened independently by two reviewers. Full-text articles were assessed using the Overview Quality Assessment Questionnaire. After data extraction a narrative synthesis was performed. We defined patient-relevant outcomes as our primary outcomes. RESULTS: We included six systematic reviews. The interventions included first contact, history taking and assessment, patient education, review of drug treatment, referrals to GPs and other health professionals, ordering further investigations and ongoing care. Two meta-analyses showed a relative risk reduction of mortality in favour of nurse-led care, whereby the reduction in one analysis was significant. The effect was highest in the group of more highly qualified nurse practitioners (RR 0.19), as opposed to nurse practitioners (RR 0.76) and registered nurses (RR 0.92). Two meta-analyses showed a relative risk reduction in hospital admissions and patient satisfaction. Whereas care conducted by physicians and registered nurses led to the same outcomes, care conducted by nurse practitioners led to better outcomes (RR 0.74). An analysis according to nursing group showed that patients were more satisfied with treatment by registered nurses (SMD 1.37) than with treatment conducted by nurse practitioners and more qualified nurse practitioners (SMD 0.17). In terms of patient-relevant outcomes, no differences were observed between physician-led care and nurse-led care in terms of physical function, quality of life and pain. CONCLUSION: Nurse-led care is probably as safe or safer than physician-led care in terms of mortality and hospital admissions. However, the impact of nursing staff training has not been sufficiently examined.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Physicians, Primary Care - administration & dosage
- Nurses - administration & dosage
- Primary Health Care - administration & dosage
- Randomized Controlled Trials as Topic - administration & dosage
- Find related publications in this database (Keywords)
- Systematic reviews
- Nurses
- General practitioners
- General practice
- Primary care
- Primary health care
- Primary care nursing
- Patient satisfaction
- Nurses' role
- Primary care physician